| NPI | 1598124380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN219928) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 30792) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 358136) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 16517) | |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2026-05-28 |